Provider Demographics
NPI:1588905111
Name:LINDQUIST, MICHELLE (MSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 VORTEX AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-6514
Mailing Address - Country:US
Mailing Address - Phone:435-773-3343
Mailing Address - Fax:
Practice Address - Street 1:754 VORTEX AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-6514
Practice Address - Country:US
Practice Address - Phone:435-773-3343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5371-S104100000X
UT6710856-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker